CAJ | 학술논문

目的：研究集束化管理对新生儿外周穿刺中心静脉导管置入（PICC ）并发症发生率和非计划拔管率的影响。方法未应用集束化管理的116例新生儿为A组，应用集束化管理的新生儿93例为B组。观察并比较两组患者并发症发生情况及非计划拔管率情况等。结果 A组治疗期发生并发症共70例（60．3％），B组25例（26．9％），B组并发症率显著低于 A 组（ P＜0．05）。在机械性静脉炎、导管阻塞、导管异位等方面发生率比较B组显著低于A组（P＜0．05）。B组总异位率及右贵要静脉穿刺异位率均显著低于A组（P＜0．05）。B组非计划拔管率显著低于A组（P＜0．05）。胎龄对并发症无影响（P＞0．05），新生儿体质量及置管日龄对新生儿并发症有影响（ P＜0．05）。结论集束化管理能降低新生儿PICC并发症发生率，减少非计划拔管率，更好地发挥PICC的作用。
목적：연구집속화관리대신생인외주천자중심정맥도관치입（PICC ）병발증발생솔화비계화발관솔적영향。방법미응용집속화관리적116례신생인위A조，응용집속화관리적신생인93례위B조。관찰병비교량조환자병발증발생정황급비계화발관솔정황등。결과 A조치료기발생병발증공70례（60．3％），B조25례（26．9％），B조병발증솔현저저우 A 조（ P＜0．05）。재궤계성정맥염、도관조새、도관이위등방면발생솔비교B조현저저우A조（P＜0．05）。B조총이위솔급우귀요정맥천자이위솔균현저저우A조（P＜0．05）。B조비계화발관솔현저저우A조（P＜0．05）。태령대병발증무영향（P＞0．05），신생인체질량급치관일령대신생인병발증유영향（ P＜0．05）。결론집속화관리능강저신생인PICC병발증발생솔，감소비계화발관솔，경호지발휘PICC적작용。
Objective To study the effects of bundles of care on complications and unplanned extubation rate of neonatal in PICC .Methods 116 cases of neonatal which didn′t accept the bundles of care ware group A ,the other 93 cases of neonatal which accepted the bundles of care ware group B .Two groups were observed and compared on the incidence of complications and un-planned extubation rate and so on .Results The complications in A group treatment were 70 cases(60 .3% ) ,while there were 25 ca-ses in group B(26 .9% ) ,the group B was significantly lower than the group A (P<0 .05) .Mechanical phlebitis ,catheter occlusion , catheter ectopic and other aspects of ectopic group B were significantly lower than in group A (P<0 .05) .The rate of unplanned ex-tubation and catheter blockage in group B were significantly lower than A (P<0 .05) .The total rate of ectopic and right basilic vein ectopic rate in group B were all significantly lower in group A (P<0 .05) .Group B unplanned extubation rate and catheter blockage weresignificantlyloweringroupA(P<0.05).Gestationalagedidn′thaveimpactoncomplications(P>0.05),birthweightand catheter days had more impact on neonatal complications (P<0 .05) .Conclusion The cluster management can reduce the incidence of neonatal PICC complications ,reduce unplanned extubation rates ,better play the role of PICC ,try to arrange an experienced staff of medical operations for children of low birth weight newborns .